Healthcare Provider Details
I. General information
NPI: 1730306911
Provider Name (Legal Business Name): PEOPLE IN NEED - LAWRENCE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/19/2007
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2703 W STATE ST
NEW CASTLE PA
16101-8671
US
IV. Provider business mailing address
2703 W STATE ST
NEW CASTLE PA
16101-8671
US
V. Phone/Fax
- Phone: 724-657-3303
- Fax: 724-657-3326
- Phone: 724-657-3303
- Fax: 724-657-3326
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 400930 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0805X |
| Taxonomy | Geriatric Psychiatry Physician |
| License Number | 400930 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P2900X |
| Taxonomy | Pain Medicine (Psychiatry & Neurology) Physician |
| License Number | 400930 |
| License Number State | PA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 400930 |
| License Number State | PA |
VIII. Authorized Official
Name:
SHARON
HODGE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 724-657-3303